Preview

Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high. The hormone insulin - produced by the pancreas - is responsible for controlling the amount of glucose in the blood.

There are two main types of diabetes:

Type 1- Pancreas doesn't produce any insulin

Type 2 - Pancreas doesn't produce enough insulin or the body's cells

don't react to insulin

Diabetes mellitus type 1 (also known as type 1 diabetes, or T1DM; formerly Insulin-Dependent Diabetes or Juvenile Diabetes) is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. The subsequent lack of insulin leads to increased blood and urine glucose. The classical symptoms are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger) and weight loss

Risk-factors for type 1 diabetes

There aren't many known risk factors for type 1 diabetes,

Known risk factors include:

A family history. Anyone with a parent or siblings with type 1 diabetes has a slightly increased risk of developing the condition.

Other dietary factors. Drinking water that contains nitrates may increase the risk of type 1 diabetes. The timing of the introduction of cereal into a baby's diet also may affect a child's risk of type 1 diabetes. One clinical trial found that between ages 4 and 7 months appears to be the optimal time for introducing cereal.

Type 1 diabetes signs and symptoms can come on quickly and may include:

Signs and symptoms of type 1 diabetes in adults:

Increased thirst

Frequent urination

Extreme hunger

Unintended weight loss

Irritability and other mood changes

Fatigue and weakness

Blurred vision

In females, a vaginal yeast infection

Signs and symptoms of type 1 diabetes in children:

Usually develop quickly, over a period of weeks. Look for:

Increased thirst and frequent urination. As excess sugar builds up in your child's bloodstream, fluid is pulled from the tissues. This may leave your child thirsty. As a result, your child may drink and urinate more than usual.

Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more

Hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes.

Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or mill moles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst.

Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.

For more details you can watch:

Treatments and drugs

Treatment for type 1 diabetes includes:

Taking insulin

Carbohydrate counting

Frequent blood sugar monitoring

Eating healthy foods

Exercising regularly and maintaining a healthy weight

The goal is to keep your blood sugar level as close to normal as possible to delay or prevent complications.

Insulin and other medications

Anyone who has type 1 diabetes needs lifelong insulin therapy. After the diagnosis, there may be a "honeymoon" period, during which blood sugar is controlled with little or no insulin. However, this phase doesn't last.

Types of insulin are many and include:

Rapid-acting insulin

Long-acting insulin

Intermediate options

Insulin administration

Insulin can't be taken orally to lower blood sugar because stomach enzymes interfere with insulin's action. Therefore, it must be given either through injections or an insulin pump.

Injections. You can use a fine needle and syringe or an insulin pen to inject insulin under your skin. Insulin pens look similar to ink pens, and are available in disposable or refillable varieties. Needles are available in a variety of sizes, so you can find one that's most comfortable for you.

If you choose injections, you'll likely need a mixture of insulin types to use throughout the day and night. Multiple daily injections that include a combination of long-acting insulin, such as Lantus or Levemir combined with rapid-acting insulin, such as Apidra, Humolog or Novolog, more closely mimic the body's normal use of insulin than older insulin regimens that only required one or two shots a day. Three or more insulin injections a day has been shown to improve blood sugar levels.

An insulin pump - a device about the size of a cellphone worn on the outside of your body. A tube connects a reservoir of insulin to a catheter that's inserted under the skin of your abdomen. This type of pump can be worn in a variety of ways, such as on your waistband, in your pocket, or with specially designed pump belts. Other medications

Additional medications also may be prescribed for people with type 1 diabetes, such as:

High blood pressure medications. Your doctor may prescribe medications known as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), because these medications also can help keep your kidneys healthy.

Aspirin. Your doctor may recommend you take baby or regular aspirin daily to protect your heart.

Cholesterol-lowering drugs. Your doctor may not wait until your cholesterol is elevated before he or she prescribes cholesterol-lowering agents known as statins.

Type 1 diabetes can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys. Keeping your blood sugar level close to normal most of the time can dramatically reduce the risk of many complications.

Long-term complications of type 1 diabetes develop gradually, over decades. Good blood sugar management can help lower the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.

Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which often heal poorly and may ultimately require toe, foot or leg amputation.

Skin and mouth conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.

Pregnancy complications. High blood sugar levels can be dangerous for both the mother and the baby. The risk of miscarriage, stillbirth and birth defects are increased when diabetes isn't well-controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia.

Complications in children

Type 1-diabetes can affect nearly every major organ in your child's body, including the heart, blood vessels, nerves, eyes and kidneys.

Heart and blood vessel disease. Diabetes dramatically increases your child's risk of various cardiovascular problems and high blood pressure later in life.

Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your child's nerves, especially in the legs. This can cause tingling, numbness, burning or pain. Nerve damage usually happens gradually over a long period of time.

Osteoporosis. Diabetes may lead to lower than normal bone mineral density, increasing your child's risk of osteoporosis as an adult.

Preventing complications:

To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having. Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes. To prevent injury to your feet, wear proper footwear, check and care for your feet every day. You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.

Check for hypoglycaemia. If any symptoms occur as shown below, eat some sugar or candy. Contact your doctor for change in medications or diet.

Typical follow-up schedule:

You should see your health care provider every 3 months.

Once detected diabetes, you should test your fasting blood sugar and post-prandial blood sugar level every month, Micro-albumin test every 3 months and eye check up every 6 months.For more details on Complications of Diabetes you can watch:

Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight.

Type 1 Diabetes in Children: Safe Exercise

Children who take insulin are at risk of hypoglycemia during and after exercise. But with good planning and awareness, a child can exercise and participate in sports safely. Good planning means checking blood sugars before, during, and after exercise. Then, you can keep a record of how exercise affects your child's blood sugars. Remember that each child will react to exercise differently. But using your records, you can usually predict how your child will react to activity.

Use the following tips for exercising safely:

Do not let your child exercise if blood sugar is over 250 mg/dL and ketones are present.

Make sure your child wears identification. Some children may prefer a temporary medical ID tattoo instead of a medical ID bracelet, especially when playing sports.

Make sure your child drinks water so he or she does not get dehydrated.

Talk with your child's doctor about lowering the insulin dose that your child takes before exercise.

Inject the insulin before exercise in a site other than the parts of the body your child will be using during exercise. For example, if your child will be running, do not inject insulin in the leg.

Have some quick-sugar food (hard candy, fruit juice, honey) on hand at all times. You can also make sure your child's coach carries quick-sugar foods.

If your child's blood sugar is below the target range before exercise, consider giving your child 15 grams of carbohydrate from quick-sugar food (hard candy, fruit juice, and honey). If your child will be exercising very hard and for longer than 30 minutes, you may want to consider another 15 grams of carbohydrate from quick-sugar food. Younger children may need less carbohydrate from quick-sugar food.

If your child plays in organized sports, give the coach a list of the symptoms of low blood sugar and instructions about what to do if it occurs.

Watch for symptoms of low blood sugar for 12 hours after exercise, especially if it is a new activity.

Your child may use a diluted (watered down) form of sports drink during activity to get fluids and sugars.

Following your diabetes treatment plan requires round-the-clock care, which can be frustrating at times. But realize that your efforts are worthwhile. Careful management of type 1 diabetes can reduce your risk of serious even life-threatening complications.

Consider these tips:

Make a commitment to managing your diabetes.

Identify yourself. Wear a tag or bracelet that says you have diabetes.

Schedule a yearly physical exam and regular eye exams.

Keep your immunizations up to date.

Pay attention to your feet.

Keep your blood pressure and cholesterol under control.

If you smoke or use other forms of tobacco, ask your doctor to help you quit.

If you drink alcohol, do so responsibly.

Take stress seriously.

Take a step back and set some limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.

Understanding and recognizing the limits of control are key elements in helping your teenager with T1D work through the challenges of adolescence. Three areas of special importance are:

Understand the Need for Spontaneity. Teens want to be spontaneous--to be able to do things, eat things, try things. T1D requires the opposite. A teen with T1D must realize that freedom only comes with knowledge and responsibility. Only by fully understanding and controlling his or her diabetes can a teen achieve the flexibility he or she craves.

Understand the Need for Control. Teens want to be masters of their own lives. They want to define their own identities. To accomplish these objectives, they have to keep testing their limits. You can help show how they can use the discipline and control of diabetes care to gain strength and mastery in other parts of their lives.

Recognize the Limits of Your Control. Be realistic. Accept the fact that you can't watch over your teen every minute of the day. You, too, have to learn that it's your child's T1D, not yours.

By no means do these suggestions mean you should turn your back on your teen and allow him or her to self-destruct. You can talk with your teen about the choices he or she is making. Talk about grown-up matters, like career, marriage, and alcohol. Talking with your teenager shows you think of him or her as an adult and helps keep the lines of communication open during this difficult period.

Get your teen involved in type 1 diabetes support groups and diabetes camps, where he or she can meet other teens with type 1 diabetes. If you believe your child is in serious trouble, don't be embarrassed about seeking professional help.

Parents and Type 1 Diabetes

Your child is not alone in struggle with Diabetes, and there's no reason to feel alone. Get involved in support groups and type 1 diabetes organizations. Your child will benefit from being around other young people with T1D, and you will benefit from sharing information and insights with other parents who know the pitfalls, frustrations, and anxieties of a life with type 1 diabetes.

Lifestyle

Positive
Changes

Weight
Management

Move those
muscles and Be Active.

Research has shown that leaner and more active
people are less likely to get diabetes (2).
To find out
your ideal weight and Body Mass Index (BMI) go to this link. Record your weight every
day.

Blood Glucose
management

Hypoglycemia (where in the blood glucose
levels drop to dangerous levels) can result in catastrophic complications. To
prevent this always keep a something to eat such as chocolate or sugar candy: also it is wise to let your near and dear ones and colleagues to know that
you are diabetic so that they can help you in such episodes of hypoglycaemia.
Please follow the link for more information on Hypoglycemia.

Keep
your blood sugar in constant check by maintaining a balanced diet and a
prudent lifestyle. Keep a track of your blood sugar at
home by monitoring it with glucometer at different intervals of the day.

Alcohol

Abstinence is
the best policy.

Alcohol is high in calories, can increase
blood pressure and blood sugar. If you
drink, ask your doctor first.

Medication

Some of the medicines used for diabetes can
have interactions with various medicines. Check with your doctor when you are
taking any new medicines.

Tobacco and Smoking

Quit!

Research suggests that tobacco use and
smoking can make diabetes worse and may lead to other eye or kidney
failures. Need help quitting, call -

the
National Tobacco Cessation Quit Line, 1800-22-77-87

To know more about the health benefits of
quitting, go to

.

Stress Management

High stress levels may increase blood glucose
levels. Incorporate a daily routine to
relax and rejuvenate -- try to listen to soothing music, chant, read a book or
meditate.

Sleep

A sound night sleep is suggested to improve
insulin use by the body. Exercise can
help inducing sleep.

Caffeine

Reduce the intake of tea, coffee, colas and
chocolate especially later in the day.
Lowered caffeine intake is known to induce a better sleep during the
night which in turn improves insulin use by the body.

Blood Pressure management

Maintaining a normal blood pressure of lower
than 120/80 is important to lower the risk of further complications. Exercise can help to maintaining normal
blood pressure

Slash down any intake of carbonated, caffeinated or alcoholic beverages.

Curb your Salt intake, as sodium in the salt has to tendency to retain water in the body which can increase blood pressure and add other complications. Do not add salt while cooking and restrict consumption of packaged food. (5)

Avoid foods with a high glycaemic index such as white rice, maida, potatoes, pineapple, banana, grapes, sapota, breakfast cereals etc. These foods increase the blood-sugar levels, for a bigger list go to

Sample Diet Plan

Below is a sample Diet Plan for a patient who is diabetic (type 2). Make sure to check the correct portion/serving sizes for each food item by going to these links.(6), (7)

Refrain from fasting and talk to your doctor or dietician about any restrictions on fluid or water intake. Do not add SALT or SUGAR while cooking or as seasoning. For cooking, try to use either Olive oil or peanut oil.

MEAL

FOOD TYPES

SOUTH (BANGALORE)

Early morning

1/4 serving of milk
products

1/2 serving of cereals

1 cup of coffee or 1/2 a cup of curd

2 Marie biscuits or 1/2 a cup of 'pongal'

Breakfast

1/2 serving of milk
products

2 servings of cereals

1 serving of
meat/poultry/milk products

1 serving of fruit

1 serving of fat

1 cup of milk/curd or 1 1/2 glasses of buttermilk

3 'idlis' with chutney or 2 'dosas' or 2 cups of 'upma'or 2 small 'idiyappams'

2 egg whites of 2 cups of curd

1 medium-sized apple/orange/guava/pear or a medium slice of papaya
or 10 grapes

1 tsp of oil/butter

Mid-morning

1 serving of fruit

1 medium-sized apple/orange/guava/pear or a medium slice of papaya
or 10 grapes

Lunch

2 servings of cereals

1 serving of
pulses/legumes

2 1/2 servings of
vegetables

1/2 serving of milk
products

1 1/2 servings of fat

1 cup of rice or 2 medium chapatis (60g)

1 cup of 'sambhar' (with 1/2 a cup of vegetables) or other dal, or 1
piece of chicken/fish (30g)

1 cup of leafy or gourd-type vegetable 1/2 cup of other vegetable 1 cup of salad

1 glass of buttermilk

1 1/2 tsp of oil

Tea &
Snacks

1/4 servings of milk
products

1/2 serving of cereals

1 cup of coffee

1 cup of rice or 'avalakki' or 1 rava idli

Dinner

2 servings of cereals

1 serving of pulses or
meat/poultry

2 1/2 servings of
vegetables

Fruit

1 1/2 servings of fat

1 cup of rice or 2 medium chapatis (60g) or 1 small 'ragi'ball

1 cup of dal or 'sambhar' with 1/2 a cup of vegetables

1/2 cup of leafy or gourd-type vegetable 1 cup of other vegetable 1 cup of salad